Results of centralized Asherman surgery 2003 2013

Hysteroscopic adhesiolysis for Asherman syndrome resulted in restoration of a healthy uterine cavity in 95% of women treated, in 1–3 attempts, with a 28.7% recurrence rate of intrauterine adhesions.

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Authors

Miriam M.F. Hanstede, M.D., Eva van der Meij, M.D., Laurien Goedemans, M.D., Mark H. Emanuel, M.D., Ph.D.

Volume 104, Issue 6, Pages 1561-1568

Abstract

Objective:

To study the success rate of hysteroscopic adhesiolysis and the spontaneous recurrence rate of intrauterine adhesions (IUAs) in patients with Asherman syndrome.

Design:

Cohort study.

Setting:

University-affiliated hospitals.

Patient(s):

A total of 638 women with Asherman syndrome were included, all diagnosed using hysteroscopy, and operated on between 2003 and 2013.

Intervention(s):

None.

Main Outcome Measure(s):

Hysteroscopic adhesiolysis was classified as successful if a normalization of menstrual blood flow occurred, along with a restored, healthy, cavity anatomy, free of adhesions, with hysteroscopic visualization of ≥1 tubal ostium. Recurrences of adhesions were diagnosed using hysteroscopy after an initial successful procedure.

Result(s):

A first-trimester procedure preceded Asherman syndrome in 371 women (58.2%) and caused adhesions of grades 1–2A. In 243 (38.1%) women, a postpartum procedure caused IUAs of grades 3–5). The procedure was successful in 606 women (95%), and restoration of menstrual blood flow occurred in 97.8%; IUAs spontaneously recurred in 174 (27.3%) of these cases. High grades of adhesions were predictive of a higher chance of spontaneous recurrence of adhesions.

Conclusion(s):

In 95% of women with Asherman syndrome, a healthy uterine cavity was restored with hysteroscopic adhesiolysis, in 1–3 attempts, with a 28.7% recurrence rate of spontaneous IUAs.

Read the full text at: http://www.fertstert.org/article/S0015-0282(15)01887-7/fulltext


Fertility and Sterility

Editorial Office, American Society for Reproductive Medicine

Fertility and Sterility® is an international journal for obstetricians, gynecologists, reproductive endocrinologists, urologists, basic scientists and others who treat and investigate problems of infertility and human reproductive disorders. The journal publishes juried original scientific articles in clinical and laboratory research relevant to reproductive endocrinology, urology, andrology, physiology, immunology, genetics, contraception, and menopause. Fertility and Sterility® encourages and supports meaningful basic and clinical research, and facilitates and promotes excellence in professional education, in the field of reproductive medicine.

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